Legislature(2023 - 2024)DAVIS 106
05/11/2023 06:00 PM House WAYS & MEANS
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| Start | |
| Overview: Mental Health Trust Authority Five-year Plan | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
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ALASKA STATE LEGISLATURE
JOINT MEETING
HOUSE SPECIAL COMMITTEE ON WAYS AND MEANS
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
May 11, 2023
6:05 p.m.
MEMBERS PRESENT
HOUSE SPECIAL COMMITTEE ON WAYS AND MEANS
Representative Ben Carpenter, Chair
Representative Tom McKay
Representative Kevin McCabe
Representative Cathy Tilton
Representative Cliff Groh
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
HOUSE SPECIAL COMMITTEE ON WAYS AND MEANS
Representative Jamie Allard
Representative Andrew Gray
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
Representative Dan Saddler
OTHER LEGISLATORS PRESENT
Representative Mike Cronk
Representative Alyse Galvin
Representative Will Stapp
Representative Rebecca Himschoot
COMMITTEE CALENDAR
OVERVIEW: MENTAL HEALTH TRUST AUTHORITY FIVE-YEAR PLAN
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
STEVE WILLIAMS, CEO
Alaska Mental Health Trust Authority
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Co-presented during the overview on the
Alaska Mental Health Trust Authority.
HEATHER CARPENTER, Health Care Policy Advisor
Office of the Commissioner
Department of Health
Juneau, Alaska
POSITION STATEMENT: Co-presented during an overview on the
Alaska Mental Health Trust Authority.
JUSDI WARNER, Executive Director
Alaska Mental Health Trust Land Office
Department of Natural Resources
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the overview
hearing on the Alaska Mental Health Trust.
ACTION NARRATIVE
6:05:19 PM
CHAIR BEN CARPENTER called the joint meeting of the House
Special Committee on Ways and Means and the House Health and
Social Services Standing Committee to order at 6:05 p.m.
Representatives McKay, McCabe, Carpenter, McCormick, Ruffridge,
and Prax were present at the call to order. Representatives
Groh, Tilton, Sumner, Fields, and Mina arrived as the meeting
was in progress.
^OVERVIEW: Mental Health Trust Authority Five-Year Plan
OVERVIEW: Mental Health Trust Authority Five-Year Plan
6:07:15 PM
CHAIR CARPENTER announced that the only order of business would
be the overview of the five-year plan for the Alaska Mental
Health Trust Authority.
6:07:41 PM
STEVE WILLIAMS, CEO, Alaska Mental Health Trust Authority
(AMHTA), Department of Revenue (DOR), began the PowerPoint
presentation, titled "Trust Budget Development Process" [hard
copy included in the committee packet]. He reviewed what the
presentation would cover and who would be available online to
answer questions. Moving to slide 2, he pointed out the list of
the Board of Trustees for AMHTA. He moved to slide 3 and gave a
history of AMHTA. He explained that prior to Alaska statehood
few mental health services were available, and people who were
deemed mentally unstable living in Alaska were sent to
Morningside Hospital in Oregon, as seen on slide 3. He stated
that many of these people never returned to Alaska, and families
did not know their whereabouts. As a result of this, once
Alaska became a state, the federal government put 1 million
acres of land to create a mental health trust. This land was to
be leveraged to produce cash to support health and social
services in the state. He stated that over time the land was
sold or granted to residents, and the money was never used to
support these services, and this resulted in the lawsuit Weiss
v. State, 706 P.2d 681 (1985), which represented the Alaskans
who had not received this support from the state.
6:13:19 PM
MR. WILLIAMS, moving to slide 4, pointed out the conditions
which would qualify individuals to receive support from AMHTA.
This includes Alaskans who experience mental illness,
developmental disabilities, substance use disorders, Alzheimer's
disease and related dementia, and traumatic brain injuries. He
stated that AMHTA also works in prevention and early
intervention services for individuals at risk of becoming
beneficiaries.
MR. WILLIAMS addressed the role of the Board of Trustees, which
is to oversee AMHTA's assets, as seen on slide 6, which read as
follows [original punctuation provided]:
versee management of Trust assets
•Spend Trust income
•Recommend to Governor and Legislature how the State
of Alaska should spend general fund resources
•Ensure the State has a Comprehensive Integrated
Mental Health Program Plan
•Advocate and serve as a change agent of the system
MR. WILLIAMS addressed AMHTA's annual budget on slide 7. He
stated that available funds are identified by using a 4-year
average of the combination of the following: a withdrawal from
invested assets, prior year's unexpended grant funds carried
forward, spendable income generated from the Alaska Mental
Health Trust Land Office ("land office") activities, and
interest income earned on cash balances. He stated that these
four categories are totaled, and this would be the projection
for expenditures.
6:16:47 PM
MR. WILLIAMS stated that once AMHTA knows the available funding,
it would set its priorities. He said that recommendations come
from the different boards, beneficiaries and their families,
community partners, tribal health partners, and state and
federal government partners. He pointed out the flow of this
process on slide 8. He added that the Comprehensive Integrated
Mental Health Program Plan (Comp Plan) is a part of this, and it
will be addressed later in the presentation.
6:19:05 PM
MR. WILLIAMS addressed the timeline AMHTA uses when developing
its budget, as seen on slide 9, which read as follows [original
punctuation provided]:
Trust Budget Development Timeline (Annual)
April Early June Trust staff working with Advisory
Boards and stakeholders to review current and plan
future work to inform proposed budget
Late June July Trust staff working with stakeholders
to finalize budget proposal
July Proposed budget presented to the Program &
Planning Committee
August/Sept. Trustees consider/approve budget
September 15 Transmit budget to Governor and LB&A
6:20:15 PM
MR. WILLIAMS, addressing what the budget includes, moved to
slide 10, which read as follows [original punctuation provided]:
Trust Budget Includes Approved Funding for:
1)Non-Focus Area Allocations
•Agency Budgets
•Other Non-Focus Area programs
2)Trust Focus Areas:
•Mental Health & Addiction Intervention
•Disability Justice
•Beneficiary Employment and Engagement
•Housing & Home and Community Based Services
3)Other Trust Priority Areas:
•Workforce Development
•Early Childhood Intervention and Prevention
6:22:25 PM
MR. WILLIAMS pointed out the summary sheet for the approved
fiscal year 2024 (FY 24) budget on slide 11, which added the
dollar amounts to the categories seen on the previous slide. He
explained the acronyms on the slide and provided details. He
moved to slide 12 to present a pie chart of the trust's FY 24
spending.
6:25:43 PM
MR. WILLIAMS moved to slide 13, which addressed AMHTA's grant-
making process. He pointed out that the Board of Trustees
authorizes around $20 million in grants each year to nonprofits,
service providers, state and local governments, and Tribal
organizations. He stated that the Mental Health Trust Authority
Authorized Receipts (MHTAAR) grants go to state agencies after
recommendations have been made. This would ensure these state
agencies have the capacity to carry out the directive. He
stated that the authority grants come directly from AMHTA to
nonstate entities. These grants are broken down into
categories, which include innovative solutions, capacity
building, equipment, capital construction, data planning, direct
service outreach, and workforce development and training. He
stated that grants cannot be given directly to individuals;
however, grants can be given to an organization which would
impact an individual, and this falls under "mini grants." These
can be up to $2,500 per award for equipment, supplies, or
services to improve quality of life and increase independent
functioning. He stated that there are also partnership grants,
which would not have a specific grantee identified. He stated
that these amounts to funds of $2.5 million, and organizations
can apply for a grant for these funds. Applications are
reviewed and if the criteria are met, the request will be
reviewed by the Board of Trustees or CEO. He stated that when
any of these grants are awarded, whether the grant is MHTARR or
through the state system, an agreement would be put in place.
He gave the details of what is included in these agreements. He
stated that AMHTA makes over 200 grants a year. He expressed
the opinion that AMHTA is a highly engaged grant maker, staying
in contact with the grantees throughout the lifespan of the
grant project.
6:30:19 PM
MR. WILLIAMS reviewed the grant application process, which
begins with a brief letter of interest. After an initial review
the applicant may receive a full grant application. The full
grant application would go through the review process. The
application must meet AMHTA's criteria, which include the
mission or priorities of the trust, any applicable regulations
or statutes, Comp Plan alignment, sustainability, and grantee
capacity. He stated that availability of trust funds would be
considered, and the applicant must be in good standing with the
state. After the review, the application would then be
presented to AMHTA's CEO or Board of Trustees for approval.
6:31:58 PM
REPRESENTATIVE MCCABE asked if capital projects could be
outlined.
MR. WILLIAMS, in response, shared several examples. He pointed
out that AMHTA is a founding partner with the Tlingit Haida
Regional Housing Authority in creating the Forget-Me-Not Manor.
He stated that AMHTA provided funding for a shelter project in
Bethel, as well as a sobering center. He continued that funding
went to Complex Care shelter services operated by Catholic
Social Services in Anchorage, and funding has also been provided
to Providence Alaska Medical Center for Anchor House. In
response to a follow-up question, he thanked Representative
McCabe for supporting the Crisis Now model. He said AMHTA is
focused on setting up crisis stabilization centers in Anchorage,
Mat-Su Valley, and Fairbanks. He said a grant was awarded to
Maniilaq Association for initial planning of Crisis Now services
in Kotzebue.
6:34:41 PM
REPRESENTATIVE COULOMBE pointed out slide 15 and questioned the
fiscal amounts that the Board of Trustees would approve.
MR. WILLIAMS explained that funding up to $100,000 is under the
authority of the CEO, while requests between $100,000 and
$500,000 are subject to approval by the Board of Trustees
Planning and Program Committee. He stated that any grant over
$500,000 requires full board approval. In response to a follow-
up question, he stated that the CEO has the authority to award
grants, but only up to $100,000. He further explained that, if
the CEO approves a grant request for $100,000, and the same
organization applies for a second grant, further funding will
need to be approved by the Planning and Program Committee.
6:36:48 PM
REPRESENTATIVE PRAX offered his understanding that the scope of
AMHTA has broadened. He asked whether the Board of Trustees has
the criteria to determine the scope of AMHTA.
MR. WILLIAMS answered that the Comp Plan is not only focused on
mental health. He explained that once the lawsuit Weiss v.
State was filed, the trust reviewed medical records from those
moved to the Morningside Hospital in Oregon to determine who was
sent out of Alaska. He stated that it was found these
individuals included those with mental health issues. He said
this was how the classes of individuals were determined. He
stated that when the lawsuit was settled, AMHTA was able to
define the beneficiary cohorts of the trust. He explained that
the scope has not been broadened; moreover, it has been defined.
In response to a follow-up question, he stated that in
determining which grants have priority, the Board of Trustees
has identified areas to focus on.
6:43:03 PM
REPRESENTATIVE RUFFRIDGE, in reference to the treatment of
children in Alaska with a mental disability, expressed the
understanding that these children are still sent out of state.
He asked how this situation is being addressed today.
MR. WILLIAMS responded that, like the state, AMHTA has a broad
mandate, and the services for all beneficiary types have to be
investigated statewide, and AMHTA has to be an advocate and
system-change agent to impact every aspect. He stated that
AMHTA is still connected to children being sent out of state for
treatment. He related that Crisis Now addresses early
intervention, which could help people from being sent out of
state. He added that the advocacy for funding home and
community-based services and reducing the administrative burden
of Medicaid on providers are also aspects which can impact
whether a child is sent out of state.
6:47:15 PM
CHAIR CARPENTER noted that there may be more information in the
next section of the presentation.
6:47:59 PM
HEATHER CARPENTER, Health Care Policy Advisor, Office of the
Commissioner, Department of Health (DOH), returned to the
PowerPoint presentation on slide 16. She said she will be
highlighting the Comp Plan. She pointed out the statutory
responsibilities for the plan on slide 17, which read as follows
[original punctuation provided]:
AS 47.30.660. Cooperative powers and duties of the
Department of Family and Community Services and the
Department of Health "The Department of Family and
Community Services and the Department of Health, in
cooperation, shall prepare, and periodically revise
and amend, a plan for an integrated comprehensive
mental health program?; the preparation of the plan
and any revision or amendment of it shall be made in
conjunction with the Alaska Mental Health Trust
Authority; be coordinated with federal, state,
regional, local, and private entities involved in
mental health services?."
AS 44.25.200. Alaska Mental Health Trust Authority:
(b)"The purpose of the authority is to ensure an
integrated comprehensive mental health program."
6:50:01 PM
CHAIR CARPENTER stated there has been confusion in the
difference between "plan" and "program" and asked what "program"
means in the context of AS 44.25.200.
MR. WILLIAMS answered that "program" refers to the whole system.
6:50:40 PM
MS. CARPENTER explained that the "plan" part would be the
document which provides a guide to ensure there is the broader
system. She continued there would need to be a "plan" before a
"program" could be built.
CHAIR CARPENTER offered his understanding that responsibility
for the plan is within the state department, while
responsibility for the program lies with AMHTA.
6:51:12 PM
MR. WILLIAMS interjected that program responsibility does not
lie within AMHTA; rather, it resides within the state, with
AMHTA being a partner helping the program.
MS. CARPENTER added that when the Weiss v. State settlement
created the trust, it was purposely put outside of the
departments responsible for running the program.
6:52:09 PM
MS. CARPENTER, returning to slide 18, pointed out the overview
of the development of the Comp Plan and how it interacts with
other public services. In response to a committee question, she
stated that how the Comp Plan and the system fit together will
be shown in a future slide.
MS. CARPENTER, on slide 19, pointed out the goals of the Comp
Plan. She said the plan includes everything impacting people's
health, and there is a statutory list of services which must be
considered. She explained that the goals were developed
mindfully because DOH has a statutory requirement to leverage
federal funds whenever possible; therefore, goals aim to
resonate with the U.S. Department of Health and Human Service's
strategic plan.
6:56:06 PM
MS. CARPENTER moved to slide 20 and pointed out that this
answers the previous question concerning the description of the
Comp Plan. She stated that it is available on DOH's website and
on AMHTA's website. She stated that AMHTA has added the
position, Comp Plan Coordinator, which is in the Public Health
Division. She stated that this position is jointly funded with
AMHTA and manages the day-to-day project management and
coordination within DOH and AMHTA.
6:57:02 PM
REPRESENTATIVE MCCABE asked if a new five-year plan is being
created, or if what is being presented is the new five-year
plan.
MS. CARPENTER responded that the goals on slide 19 are in the
current plan which goes through 2024. She said that future work
includes the planning process for the next five-year plan. In
response to a question concerning the funding for the plan, she
answered that the coordinator works for the state as a DOH
employee. She said this is a jointly funded position, with
AMHTA paying half. In response to a follow-up question
concerning who crafts the plan, she explained that there is a
statutory obligation to include advisory boards, such as the
Alaska Mental Health Board and the Advisory Board on Drug and
Alcohol Abuse, the Alaska Commission on Ageing, and the
Governor's Council on Disabilities and Special Education. Mr.
Williams added that the plan is also put to public comment as
well.
REPRESENTATIVE MCCABE questioned the plan development process
and the cost.
MS. CARPENTER shared that she was a legislative staffer for some
of the Comp Plan development process before transferring to DOH.
She said the development process is collaborative with in-person
and hybrid meetings. She added that to be cost effective there
will be more meetings held through media conferencing.
MR. WILLIAMS added that many plans were reviewed to inform how
the Comp Plan would look at services and supports.
7:02:56 PM
REPRESENTATIVE MCCABE questioned the goal on slide 19 concerning
early childhood.
MS. CARPENTER referred to the document, titled "Strengthening
the System: Alaska's Comprehensive Integrated Mental Health
Plan" [included in the committee packet]. Concerning the goal,
she read the objectives from page 5, which read as follows
[original punctuation provided]:
1.1 Objective: Promote practice-informed, universal
screening efforts and early intervention services.
1.2 Objective: Provide ongoing support to ensure
accurate identification and treatment of social-
emotional needs for children and their caregivers,
congruent with their cultural identification.
1.3 Objective: Reduce the instances and impact of
Adverse Childhood Experiences (ACEs) through community
engagement and by improving social determinants of
health.
7:04:11 PM
REPRESENTATIVE MINA questioned the evaluation process at the end
of a 5-year plan and how it is determined whether objectives and
goals are being met.
MS. CARPENTER responded that data on the scorecard from Alaska's
Health Improvement Plan ("Alaska Scorecard") determines if the
plan is on track. In response to a follow-up question
concerning past plans, she replied that the next slide will
answer the timeline.
7:06:06 PM
MR. WILLIAMS, acknowledging Representative Mina's question,
moved to the slide titled "Timeline" [original punctuation
provided], which read as follows:
Timeline
Where We Started:
•1994, the Trust is created, the settlement requires
budget recommendations based on the Comp Plan.
•FY95-97, 1stbudget recommendations
What Happened:
•FY97-98,1stactual Comp Plan: In Unison
•FY2001-2006, 2ndComp Plan: In Step
•FY2006-2011, 3rdComp Plan: Moving Forward
•2008-2020, Annual Scorecard published based on
desired outcomes of Moving Forward
•2018, planning efforts for a new Comp Plan begin
Where We Are Now:
•FY2020-2024, 4thComp Plan: Strengthening the System
•2020, new Scorecard workgroup begins
•March 2021, new Alaska Scorecard released based on
Strengthening the System; updated annually
Where We're Going:
•FY23-24, planning efforts to revise the Comp Plan
•FY 25, new Comp Plan adopted
MR. WILLIAMS explained that there have been several Comp Plans
over the years and the length of the plans have varied. He
pointed out the difference between the current plan and past
plans. He stated that the current plan looks at the
comprehensive system and the impacts on some of the health
outcomes. Moving back to slide 18, he explained that there are
several different variables involved in achieving healthy
outcomes for Alaskans, such as employment, housing, and contact
with the justice system. He stated that in the past these
aspects, along with looking at individuals holistically, have
not been the focus.
7:07:58 PM
REPRESENTATIVE FIELDS observed the rationality of the Comp Plan
and the amount of work that has been done by the departments and
commissioners.
7:08:58 PM
MR. WILLIAMS, on slide 22, stated that the current plan takes a
systems level, policy approach and is set up so the gaps and
objectives are obvious. He stated that this helps drive the
conversation on the trust's funding decisions. He stated that
grantees applying for trust funds cite the Comp Plan. He
expressed excitement that the plan is being used and expressed
hope that the trajectories on the indicators outlined on the
Alaska Scorecard change. He pointed out that the current plan
has a strong focus on prevention and early childhood
intervention. He suggested that the early intervention has
better outcomes, making it less likely someone will be sent out
of state.
7:11:24 PM
MS. CARPENTER, moving to slide 23, presented the 2022 Alaska
Scorecard. She stated that the Alaska Scorecard is a data
measurement tool which reviews key issues impacting trust
beneficiaries. She stated that it examines population health
outcomes of Alaskans receiving care and services. She explained
that the Alaska Scorecard workgroup is formed from various
department staff, and it meets biweekly for a year to prioritize
the most meaningful measures to capture the outcomes of the Comp
Plan.
MS. CARPENTER, moving to slide 25, addressed the next step for
the Comp Plan. She stated that work on the next update will
begin late 2023 for the 2025 to 2029 plan. She stated that
development will be led by DOH and Department of Family and
Community Services (DFCS), in coordination with AMHTA, and this
will be informed by additional stakeholders and public comment.
7:14:46 PM
MR. WILLIAMS stated that when the current Comp Plan was being
drafted, one of the grounding tenements was that it be a living
document, evolving over time. He concluded the presentation on
slide 26, which addressed AMHTA's budget concerning the Comp
Plan. He pointed out that this has already been discussed
during the presentation. He ended by pointing out AMTHA's goal
of driving down the numbers of incarcerated mentally ill
patients.
7:16:35 PM
REPRESENTATIVE MCCABE, concerning how many acres are under
noncash assets, requested that the value of the fund be
addressed.
MR. WILLIAMS answered that the total value of the trust at the
end of FY 22 was $500 million. He stated that there are also
restricted and unrestricted budget reserves, which total $200
million, and this is managed by the Alaska Permanent Fund
Corporation and DOR. He said the trust's commercial real estate
equity totals $73 million.
REPRESENTATIVE MCCABE questioned the number of acres the trust
has and how much was made by land sales.
7:19:04 PM
JUSDI WARNER, Executive Director, Alaska Mental Health Trust
Land Office, Department of Natural Resources, responded that the
trust owns about 1 million acres, including surface and
subsurface, with ABOUT 600,000 acres being surface. She said
the trust sold 2.5 percent of the surface acreage out of trust
ownership. In response to a follow up question, she stated that
land sales in the current fiscal year to date are nearing $3
million.
7:20:47 PM
REPRESENTATIVE PRAX questioned the land office's plan for
managing its inventory. He offered his understanding that some
of the land within the trust is for resource development. He
questioned the determination of the value of trust land in
reference to resource development.
MS. WARNER addressed the land management question. She said the
trust strategically manages the land through a resource
management strategy, which evaluates economic conditions in the
areas where the trust owns land. She said this is vetted
through a public process and the Board of Trustees. Concerning
the question about the value determinations, she stated that the
land office's mission is to maximize revenue from lands owned by
the trust. She explained that, when land development projects
are examined, the maximum revenue going back to the trust is
measured. She further explained that this requires a
recommendation from the trust. In response to a follow-up
question, she stated that a resource management strategy is
required by law and is on the website.
7:25:10 PM
MR. WILLIAMS, in response to a series of questions from
Representative Ruffridge, stated that the projected figure for
the total annual draw rate for expenditures to grants for FY 24
is $30 million. Concerning how much of the draw is done yearly
to manage grants, he returned to slide 12, pointing out that for
FY 24 spending, a 4.25 percent draw would be made off the fund's
four-year average. He answered that the yellow section of the
pie chart on slide 12 denotes funds going to the state system,
MHTAAR, while the green section denotes funding that goes
outside the state system and to local governments and nonprofits
which support services for beneficiaries. Concerning whether
there is a constitutional authority directing that a percentage
of the funding must go to the state or nonprofits, he responded
that there is no statutory formula directing the trust to expend
a portion of its funds through the state system, versus to the
community. He noted that the figure for state services, which
is currently $9 million, tends to go up and down in value.
7:29:51 PM
MS. WARNER, in response to a question from Representative McCabe
concerning whether there would be an investment into the
governor's proposed carbon offsets, stated that the land office
has been considering carbon sequestration and direct timber
resources for over 10 years, and it may be closer now. She said
that there is a likelihood the trust fund office will move
timber resources into the carbon credit program.
MR. WILLIAMS, in response to a follow-up question, stated that
the legislature does not grant money to the trust, nor does it
grant money for the trust. He stated that only the Board of
Trustees can authorize the expenditure of trust funds. He
explained that, when the MHTAAR fund goes through the state
budget process, the legislature is providing the receipt
authority to the department to use MHTAAR funds.
7:32:05 PM
CHAIR CARPENTER, regarding the statutory requirement to divert
excess revenue to the general fund, asked how AMHTA determines
what is excess revenue.
MR. WILLIAMS responded that he could provide an answer in
writing at a later time. He said the bottom line is that the
trust grants out about $37 million, while the need far exceeds
$30 million.
7:32:56 PM
REPRESENTATIVE MCKAY conveyed to Ms. Warner the work that went
into HB 49 regarding carbon offsets. He asked if the trust is
waiting for the bill, and whether it can operate independently
in making contracts.
MS. WARNER responded that the trust land office does not need HB
49 to enter the carbon market or contracts regarding carbon. In
response to a follow-up question, she answered that the trust is
18 months out for signing a carbon contract, and the acreage has
not been determined yet. She said the trust recently completed
a land exchange with the U.S. Forest Service, and active
contractors are harvesting timber from these lands. She
explained that the trust is looking at not including active
timber harvests in the carbon program. She stated that the land
office has its own statutes and regulations which allow for this
operation.
REPRESENTATIVE MCKAY commended AMHTA for doing the program and
for developing its lands.
7:37:39 PM
REPRESENTATIVE COULOMBE opined on the goals of AMHTA. She asked
how the trust could pivot if it has several boards and
departments to work with. She further asked for insight on how
the AMHTA's grants fit its goals.
MS. CARPENTER answered that the Comp Plan was built with the
goal of "strengthening the system;" therefore, the goals were
written with overarching thoughts on population health in mind.
She provided an example of when AMHTA had to pivot. She
described that the trust inherited a lawsuit when the Alaska
Psychiatric Institute was in crisis, and a judge made a ruling
in 2019, so the trust had to pivot in order to ensure Alaskans
are receiving care. She recalled that this Comp Plan was
presented to the legislature in 2020.
7:44:20 PM
REPRESENTATIVE MINA questioned the role AMHTA plays in the 1115
Medicaid Demonstration Waivers.
MS. CARPENTER answered that, in terms of Medicaid, the trust
pays for services; however, it cannot pay for the work a
provider would do to stand up a service, like a building or
training. She said AMHTA has invested in electronic health
records via the fiscal notes for SB 74.
7:45:45 PM
MR. WILLIAMS added that the trust does not have the resources to
pay for services provided by Medicaid. He said the value of
AMHTA is its ability to help, start, pivot, and enhance services
where other fund sources cannot. He explained that AMHTA was a
heavy investor in starting up the infrastructure of the Medicaid
waiver because there were no other state funds available. He
said that AMHTA can also be a player in providing bridge funding
for organizations.
7:47:50 PM
CHAIR CARPENTER pointed to the suicide prevention section on
page 4 of AMHTA's 2022 Alaska Scorecard [included in the
committee packet]. He further pointed to the document on page
27, titled "Strengthening the System Comp Plan," in reference to
the goal which would ensure Alaskans have access to a
comprehensive suicide prevention system. He questioned the
budgets in reference to these objectives on these pages and how
measuring for the effectiveness of each program is determined.
MR. WILLIAMS responded that the Alaska Scorecard has this data,
and the data on pages 27 and 28 of "Strengthening the System
Comp Plan" is going in the wrong direction. He said it is not a
signal of a failure in the system, rather outside factors may
have affected the rates, and this has caused people to go the
wrong direction.
CHAIR CARPENTER interjected to say that AMHTA's mission is to
maintain an effective services for Careline Alaska. In order to
understand whether the program is helping people, he questioned
the measure of performance of Careline Alaska.
MR. WILLIAMS answered that the Alaska Careline is funded through
DOH, and it would have the data on the number of calls received
and the subsequent outcomes.
CHAIR CARPENTER questioned the location of the documents which
would show DOH's results.
7:54:48 PM
MS. CARPENTER responded that she would follow up and provide
more information about the careline and suicide prevention,
which are funded through a grant. She shared that in July of
last year, Careline Alaska launched "988" to allow people who
are in crisis to reach the call line.
CHAIR CARPENTER stressed that the question is broader than this.
He expressed concern about the whole Comp Plan, in that he
cannot tell from the documents or the budget if this is an
effective use of funds authorized by the legislature.
MS. CARPENTER responded that she would relay these comments to
trust leadership.
7:56:45 PM
REPRESENTATIVE PRAX commented that the legislature is supposed
to interface with DOH and DFCS, per the Executive Budget Act.
He suggested that AMHTA is not subject to the Act, as it is a
corporation of the state, not a part of the government. He
questioned how and where the legislature should look at the
goals. He questioned how these goals should be reviewed.
MS. CARPENTER responded that the goals are in the budget
documents. She said these can be brought back before the
committees.
7:58:33 PM
CHAIR CARPENTER thanked the presenters.
7:59:06 PM
ADJOURNMENT
There being no further business before the committees, the House
Special Committee on Ways and Means and the House Health and
Social Services Standing Committee meeting was adjourned at 7:59
p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| MHTA grant application.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| Scorecard 2022.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| MHTA transactions.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| MHTA-0002-2301_Grant_Investment_Report_-_web_version_FINAL.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| 22-MHT-0400-FY21-Grant-Investment-Report-3C-LG-WA.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| Annual Report 2021.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| Annual Report 2022.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| Department of Justice report.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| May 11 (H) WM and HSS Meeting PPT 5.10.23.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| Mental Health Trust five yr plan.pdf |
HW&M 5/11/2023 6:00:00 PM |
|
| MHT charter of executive committee.pdf |
HW&M 5/11/2023 6:00:00 PM |